Showing 3 results for Najafi M
Najafi Mr, Tamizi Far B,
Volume 59, Issue 5 (9 2001)
Abstract
The use of Antiepileptic drugs (AEDs) in children may be associated with adverse effects especially behavioral and cognitive and teratogenic potential effects. The main propose of this study was to find an answer to the question of which factors in EEG of patients before AED withdrawal could have prognostic role in our decision. We studied 106 children whom their medication had been withdrawn 2 years after their last seizure. Before starting of this, an EEG was recorded and interpreted by an expert neurologist. Many variables such as background activity, focal spike, generalized sharp and spik waves, focal slowing, in comparison with the EEG of patient at the time of diagnosis, and also final result of the trace interpret also examined. Follow-up visits were scheduled every 3 months at least for one year. If seizure relapsed, AEDs was resumed and follow up terminated. The overall probability of remaining seizure free was analyzed as a function of time by Kaplan-Meier survical analysis. Prognostic factors affecting seizure relapse were evaluated by using the log-rank test. The overall probability of seizure recurrences was 24.8 percent (95 percent C.I, 22.5 to 28.5) at 12 months. EEG comparisons with previous times were a significant factor for prediction of relapses. Relative risk of this factor was about 1.98 (95 percent C.I, 1.01 to 3.91) (P<0.05). We found that EEG interpretation at the time of diagnosis was not a significant factor but if it divided by sex, there is a significant difference in gender (P=0.06). According to our study the rate of AED withdrawal in children is small. The benefits of continuing AED therapy must be weighted against the risk of potential adverse effects. EEG comparison with previous traces could be evaluated as a prognostic factor before AED withdrawal in children.
Najafi M, Haghighat B, Ahmadi H,
Volume 65, Issue 1 (5 2008)
Abstract
Background: Atrial and ventricular arrhythmias are among the most common complications after coronary artery bypass graft (CABG) surgery. Previous studies demonstrated that cardiopulmonary bypass itself results in reduced serum magnesium levels. In this study, we evaluated the effect of total blood magnesium level (TMG) on the prevention of perioperative arrhythmias with routine regimens of 2-4 grams supplemental magnesium (SMG).
Methods: TMG was measured in patients who were scheduled for CABG on three occasions: just before anesthesia, just after entering the intensive care unit (ICU) after completion of the sugery, and on the first morning after the operation. Patients were evaluated for primary cardiac rhythm and other variables that could have an influence on the magnesium level, including serum creatinine, urine output in the operating room and diuretic therapy. The SMG dosage was also recorded in the operating room and ICU. Patients were then evaluated for the rate and type of arrhythmia for the next three days.
Results: The mean TMG levels in 174 cases were 2.2 (0.5), 2.6 (0.6) and 2.4 (0.6) mg/dl for the three occasions, respectively. The mean SMG was 2.5 (1.2) grams. Of 164 patients, 51 (31%) developed the following post-operative arrhythmias: AF (7.3%), non-AF SVA (15.2%) and ventricular (16.5%). The mean serum creatinine level and urine output were 1.2 mg/dl and 1800 ml, respectively. Although there was a significant difference between the TMG levels on the three different occasions (P<0.001), all values were within normal range. When we stratified the TMG levels of the patients based on administered SMG, the Mentel-Haenszel test revealed no significant difference between the first and third TMG (P=0.6). Although the TMG levels were higher in arrhythmic patients compared to those without arrhythmia (2.25 vs. 2.14 mg/dl), both values were within the normal range and there was no significant difference between the two groups. Serum creatinine levels and urine volume were not related to TMG levels.
Conclusion: This study indicates that routine magnesium administration has no significant effect on SMG levels. Also, serum creatinine and urine output are not determinant factors for SMG administration. There was no correlation between TMG levels and perioperative arrhythmia. We conclude that the routine regimen of magnesium administration has no effect on the incidence of perioperative arrhythmia, though it is necessary for maintaining normal magnesium levels.
Najafi F, Ghaffarpour M, Najafi M R, Aghamohammadi A, Saadatnia M H,
Volume 66, Issue 1 (30 2008)
Abstract
Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system with multifocal areas of demyelination. Despite an increased understanding of the mechanisms causing MS, immunological factors that indicate disease activity are only starting to be discovered. Chronic brain inflammation is often associated with an increase in production of IgG in the CSF as determined by the IgG index (normal ≤0.77) and oligoclonal bands (OCBs). Different studies have found variable correlations between these two factors and disease progression. We herein evaluate the correlation of IgG index and OCB with disease progression in Iranian MS patients.
Methods: The IgG index was measured in 54 patients with multiple sclerosis. The progression index (PI), type of disease course and the presence of OCBs were compared in patients with normal, high and very high IgG index.
Results: PI was higher in patients with very high IgG indexes (0.10±0.13) vs. patients with high (0.06±0.05) and normal IgG indexes (0.05±0.07 p>0.05). Secondary progressive (SP) patients had higher IgG indexes than those with relapsing-remitting (RR) courses (2.04±1.24 for SP vs. 1.78±1.45 for RR p>0.05). The PI was higher in OCB-positive MS patients (0.08±0.10) vs. OCB-negative patients (0.05±0.04) (p>0.05).
Conclusion: Although the findings of this study need to be treated with some caution since this is not a prospective evaluation, the results indicate a trend toward better prognosis of the disease in patients with lower IgG index values. We think that the IgG index is a useful marker of disease activity in MS. Patients with IgG indexes above 1.1 could have an increased risk of progression and they would benefit from early treatment with immunomodulator agents. Our results did not reveal statistically significant prognostic value for IgG index in patients with multiple sclerosis. Thus the results warrant prospective studies to verify the prognostic value of intrathecal IgG synthesis in multiple sclerosis.
